Chronotropic Response and Risk Factors for Cardiovascular Disease in Patients with Rheumatoid Arthritis: A Cross-Sectional Study

Ahmad M Osailan; George S Metsios; Joan L Duda; George D Kitas; Jet J C S Veldhuijzen van Zanten; Ragab K Elnaggar

doi:10.3390/jcm12237256

Chronotropic Response and Risk Factors for Cardiovascular Disease in Patients with Rheumatoid Arthritis: A Cross-Sectional Study

J Clin Med. 2023 Nov 23;12(23):7256. doi: 10.3390/jcm12237256.

Authors

Ahmad M Osailan^{1

2

3}, George S Metsios^{2

4}, Joan L Duda³, George D Kitas^{2

3}, Jet J C S Veldhuijzen van Zanten^{2

3}, Ragab K Elnaggar^{1

5}

Affiliations

¹ Health and Rehabilitation Sciences Department, College of Applied Medical Sciences, Prince Sattam bin Abdulaziz University, Alkharj 16278, Saudi Arabia.
² Department of Rheumatology, Dudley Group NHS Foundation Trust, Dudley DY1 2HQ, UK.
³ School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham B15 2TT, UK.
⁴ School of Physical Education and Sport Science, University of Thessaly, 42130 Trikala, Greece.
⁵ Department of Physical Therapy for Pediatrics, Faculty of Physical Therapy, Cairo University, Giza 12613, Egypt.

Abstract

Background: Individuals with rheumatoid arthritis (RA) are at a high risk of cardiovascular diseases (CVD). A reduced chronotropic response (CR), which produces exercise intolerance, is known to be a contributing factor to CVD and mortality. Studies have shown that patients with RA have a reduced CR. However, knowledge of CR-related factors in patients with RA is limited. This study aimed to explore CR-related factors, including CVD risk factors, inflammatory markers, and cardiorespiratory fitness (VO_2PEAK).

Methods: A total of 106 RA patients underwent a treadmill test, heart rate monitoring, and various assessments, including serological CVD risk factors, inflammatory markers, and VO_2PEAK.

Results: A total of 34% of participants demonstrated a reduced CR (≤80%). Body mass index, HOMA, hsCRP, and fibrinogen were inversely related to CR, while HDL, QUICKi, VO_2PEAK, and RER exhibited a positive association. HDL and VO_2PEAK emerged as independent CR-related factors in regression analysis.

Conclusions: The current findings suggest that reduced CR in RA is associated with several CVD risk factors, inflammatory markers, and cardiorespiratory fitness. Future studies should investigate the effects of controlling these associated variables on CR in patients with RA.

Keywords: cardiovascular diseases; chronotropic response; exercise testing; rheumatoid arthritis.

Grants and funding

The data gathered in this study was obtained from a research project that was funded by the Medical Research Council National Prevention Initiative Phase 3 (G080212). And the APC was funded by A.M.O.